Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 7 Sept 2026Clinical review pending
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New symptoms need a new assessment
A rehabilitation programme does not explain new focal neurological signs, sudden hearing loss, severe headache or abrupt deterioration in balance.
Action: Stop the exercise session and arrange the appropriate urgent assessment for new neurological, auditory or other acute warning features; protect anyone unable to stand or walk safely from falls.
Synopsis
Select and progress an individual exercise programme for vestibular impairment, using meaningful functional goals, tolerable symptom exposure and explicit reassessment of unsafe or changing symptoms.
Rehabilitation helps the nervous system adapt to impaired vestibular information.
Choose exercises according to gaze, balance and movement-related functional deficits.
Confirm that an acute dangerous cause has been assessed before starting a home programme.
Key red flags
New diplopia, weakness, dysarthria, sudden hearing reduction or severe headache during a rehabilitation course requires assessment of the new event.
Investigation priorities
01
Baseline functional and vestibular assessmentFirst step
Define the deficits that the programme is intended to improve.
Management branches
PrepareAgree a safe starting programme
Assessment identifies persistent vestibular-related limitations suitable for exercise treatment.
Set one or more concrete functional goals and explain why the chosen exercises address the identified deficit.
Demonstrate a small initial set, confirm the patient can reproduce each movement and specify support, duration, frequency and a tolerable symptom response.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 7 Sept 2026; clinical approval remains outstanding.